Monday, July 9, 2012

New layers of complication...

So I need to take a step back from my discussion of diabetes for one post and talk about something else significant that is going on with me medically.  In exchanging phone calls with my pregnancy doctors down in Virginia, they informed me that I have "complete placenta previa"and that this condition elevates my theoretically high risk pregnancy because of diabetes to a new level of high risk due to an actual complication.

For those who are not familiar with the condition, here's the general gist:  placenta previa is caused when the fertilized egg embeds itself near or on the cervix rather than anywhere else on the uterine wall.  This creates a problem as the baby grows because the placenta can partially or completely cover the cervix which prevents the mother from a having safe vaginal delivery.  In some cases of partial placenta previa, as the uterus grows the placenta will be pulled upward away from the cervix and gradually reduce the complications caused by it's early low placement.   In complete placenta previa - apparently which I have - this is not the case and the issues caused by this unfortunate implantation site only increase in concern and severity as the pregnancy wears on...

What this means:

  • There is no possibility whatsoever of a vaginal delivery and I will require a c-section.
  • There is risk of fetal and maternal hemorrhaging that will, at some point shortly, require I be placed on bed rest.  What degree of bed rest is yet to be determined. 
  • If/when hemorrhaging occurs, heavy or excessive bleeding may result in an emergency c-section (regardless of gestational age) for life saving (both maternal and fetal) purposes.
  • If hemorrhaging is uncontrollable, blood transfusions may be necessary.
  • Expected delivery will be moved up to somewhere between week 36 and 38 rather than in between weeks 38 and 39 because of diabetes or week 40 for normal pregnancies.  Earlier delivery than week 36 is possible if there are life threatening complications. 

There are of course other issues that go into this condition, but I am trying very hard to remain as positive as possible at this point so as to not go into the downward spiral of "what ifs..." unless they become personally relevant to this pregnancy.  It is definitely very concerning to me that there is an additional level of issues that we need to keep in mind and that my diabetes isn't the only medical problem to be tracked...  I mean the fact that these conditions aren't even remotely correlated and that this second layer of complication is a completely out of the blue, new issue is enough to throw my mind for a complete loop.  Certainly makes the idea of "just" a diabetic pregnancy sound good right about now...

I will admit that I'm definitely disappointed that I won't be allowed a vaginal delivery since that was - no kidding - the part of this pregnancy I was most looking forward to.  I logically understand that a c-section is required to keep me and the baby alive, but I am emotionally struggling with the fact that an experience I so treasured with physically giving birth to GW is medically out of the question for Baby.  Don't get me wrong, I am completely on board with everything the doctors tell me to do to take care of this little one - heck I've been taking care of this baby since November and I wasn't even pregnant until March! - but the emotional and mental toll of diabetes and placenta previa is exhausting.

Here is a link to the Mayo Clinic page on placenta previa for those of you who are curious to know more - http://www.mayoclinic.com/health/placenta-previa/DS00588/.  I've got another appointment later in this week with the docs here in VT (oh joy...) that I plan to ask more detailed questions about what this means and how we're going to handle it, so I'll keep you posted as more information becomes available.   In the mean time, keep Baby and me in your prayers - I'm doing everything I physically can, the rest is up to God.

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